Local Planning and Network Development (LPND)

1. Local Planning and Network Development(LPND) 2010 Template Training for LMHAs

2. General • Aim for concise communication of requested information • Use bullet format whenever possible • Limit completed plan to 25 pages • DSHS will request additional information if needed • Note items that do not require response if an LMHA has no interested providers

3. Local Service Area

4. Basic Data • DSHS provides data table in MBOW: 2010 LMHA Area and Population Stats (in the General Warehouse folder)

5. Major Population Centers • Major population centers provide context for evaluating feasibility of network development • Population center may be a city and/or county • List all counties if the LMHA has a compact service area with even population distribution • Refer to MBOW report for data

6. Other Significant Information • Use bullets to provide any other significant information that affects service delivery • Include only those characteristics that set your local service area apart from most others • Consider cultural and demographic profile • Be selective

7. Provider Availability Assessment

8. Provider Recruitment • List steps taken to identify and recruit providers in past two years • Cycle I procurement • Other efforts to attract providers • Methods used to identify potential providers for Cycle II

9. Provider Availability • List current contractors, written inquiries, providers listed on DSHS website • Summarize follow-up contact • Describe availability, services offered, and capacity

10. Local Planning

11. Guidelines for Community Input • Conduct provider assessment before gathering community input • Scope and focus of input will depend on availability of external providers • Seek guidance on network development based on knowledge of provider availability at the time • Limit content to information specific to network development

12. Guidelines for Community Input • Local community determines how to develop the network • Ensure stakeholders understand rule’s mandate to expand network when providers are available • Engage stakeholders to develop plan for using available external capacity based on local needs and priorities

13. Guidelines for Community Input • If you have no interested providers, focus input on other elements of the plan • Reducing barriers to new providers • Potential strategies to attract new providers • Improving choice and access • Note sections of the plan that do not require response if you have no interested providers

14. Guidelines for Community Input • Use previous plan as the starting point for discussion, including procurement results • Before finalizing plan, review DSHS website to identify any additional providers

15. Status of Provider Assessment • New providers may be identified after initial provider availability assessment • Decisions for network expansion based on community input and the additional provider information

16. Community Engagement

17. Community Engagement • List activities used to gather input • Document participants • Variety of formats may be used: in-person, telephonic, electronic • List surveys and similar activities first • List events in chronological order • Summarize input gained from each activity

18. PNAC Involvement • PNAC must be actively involved • Reviewing community input and provider availability assessment • Recommending plan content • Reviewing draft plan • Reviewing public comment and response

19. Provider Network Development

20. Contract Expenditures

21. Contract Expenditures • Document expenditures for FY 2009 and the first six months of FY 2010 • Total expenditures includes all service dollars: internal and contract • Separate tables for adult and children’s services • Expenditures broken out by grid category

22. FY 2010 Provider Contracts • List current contractors and services provided • Indicate organization vs. individual practitioner • State dollars allocated: • total contract amount • any cap on billing under open enrollment (per provider or for all external providers)

23. Network Development

24. Network Development • Presents past, current, and planned procurement in one table • Separate tables for service packages and discrete services • Leave cells blank if NA or 0% • Enter service package capacity even if service packages not targeted for contract

25. Network Development • Column A: Document current capacity for all service packages • Use footnote if projected capacity differs significantly • Determine capacity using MBOW report: PM Service Target LPND (Utilization Management: UM Service Delivery: PM Service Target LPND)

26. Past and Current Contracting • Column B: Percent capacity contracted in 2009 (maximum possible) • Column C: Percent capacity served by contractors in 2009 (actual) • Column D: Percent current capacity contracted for 2010 (maximum) • Column E: Percent capacity served in first six months of 2010 (use 6 month figures in numerator and denominator)

27. Planned SP Procurement • Columns F and G: Enter percent of SP capacity to be procured in 2010 and 2011 • Separate columns allow phased procurement • Leave blank if only discrete services will be procured • Column H: Available providers according to provider assessment

28. Planned SP Procurement • Column I: Enter applicable condition to justify the level of service the LMHA will continue to provide • Conditions defined by the rule • Include all conditions that apply • Enter NA if 100% to be procured

29. Condition 1 • Willing and qualified provider are not available. • No providers expressed interest. • Interested providers clearly not qualified. • One or more providers expressed interest on website, but follow-up discussion clarifies lack of interest in providing complete service package.

30. Condition 2 • The external network does not provide minimum levels of consumer choice. • Use this condition if only one external provider is interested in contracting with the LMHA

31. Condition 3 • The external network does not provide equivalent access to services. • Use this condition if access is the only reason the LMHA will not use all of the available external capacity. • Applicability of this condition will probably be made after procurement.

32. Condition 4 • The external network does not provide sufficient capacity. • Use this condition if the LMHA will use all of the available external provider capacity and directly provide the balance of current capacity.

33. Condition 5 • Critical infrastructure must be preserved during a period of transition. • Use this condition if the LMHA will not use all of the available external provider capacity. • This allows the LMHA to plan a phased transition to full utilization of external provider capacity, increasing the volume of contracted services over two or more planning cycles.

34. Condition 6 • Existing agreements restrict LMHA’s ability to contract services OR • Under existing circumstances, LMHAs would lose substantial revenue if service contracted to external providers

35. Procuring Discrete Services • Enter discrete or crisis services with past and or current contracting, or planned procurement • Current service capacity is average monthly capacity based on service data from FY 2009 and FY 2010 through most recent closed quarter • Express capacity as units of service delivered

36. Rationale for LMHA Service Delivery • Describe overall rationale for: • Services selected for procurement • Volume to be procured • Services not selected for procurement • Discuss adults and children/adolescents separately • Certain conditions require additional information

37. Rationale for Condition 3 • Condition 3: Network does not provide equivalent access • Describe basis for determination • Identify source of data • Maintain supporting documentation

38. Rationale for Condition 4 • Condition 4: Network does not provide sufficient capacity • Capacity needed • External provider capacity (based on provider assessment) • Information and method used to determine external network capacity

39. Rationale for Condition 5 • Condition 5: Protection of critical infrastructure • Planned transition period • Year in which LMHA anticipates procuring the full external provider capacity currently available • Only one entry is required if the same transition period planned for all services

40. Rationale for Condition 6 • Existing agreements restrict procurement or procurement would result in substantial revenue loss • Describe each agreement or circumstance • Note agreement end date • Describe any steps taken to amend agreements or alter circumstances

41. Rationale for Volume to Preserve Financial Viability • Applicable only if the specified volume is due to the need to preserve financial viability • Related to economies of scale • Consider ability to share resources with other services • Explain budget rationale • Maintain supporting documentation

42. Strategies to Protect Critical Infrastructure • Describe strategies to protect critical infrastructure and promote a stable, successful provider network • LANAC compiled list of possible strategies (will be posted on DSHS website when finalized) • Provider education and support • Appropriate standards and oversight • Advance arrangements to rebuild lost capacity

43. Time to Re-establish Lost Service Capacity • List services separately if time varies • Consider use of external providers • Discuss external provider ability and willingness to expand capacity during provider availability assessment

44. Procurement

45. Structure of Procurement

46. Structure of Procurement • Identify geographic area and percent of clients living in the area • Rationale must address: • Method of procurement • Procurement of discrete services • Bundling of services or service packages • Service area (entire service area vs. selected counties, choice of counties)

47. Fidelity and Continuity of Care • Rule prefers procurement of service packages to preserve continuity of care and fidelity • If discrete services will be procured, present plan to preserve fidelity, avoid fragmentation and promote seamless service delivery • Address complications of multiple providers and multiple service locations, as applicable

48. Enhanced Staff Qualifications • Complete only if you require an individual practitioner type to meet qualifications that exceed the DSHS requirements

49. Consumer Choice

50. Single Provider • Identify services to have only one provider and rationale (economic factors or other) • Single provider services do not default to LMHA • Enter NA if no interested providers